The Piedmont 65+ Dental Study has followed epidemiologically for three years a randomly selected cohort of North Carolina adults aged 65 and older, collecting and analyzing data on the incidence, risk factors, and relevant biological markers for coronal and root caries, periodontal attachment loss, and tooth loss. The study has collected data from dental examinations and interviews conducted in the subjects' homes by calibrated examiners, with analyses focusing on elucidating and describing differences in oral disease risk factors and distributions between elderly blacks and elderly whites. The competing continuation now being proposed includes the continued longitudinal follow-up of an estimated 450 dentate subjects through five years and an estimated 310 subjects through seven years. The proposed follow-up study would: continue to track the natural history of caries, periodontal disease, and tooth loss in this elderly cohort of blacks and whites; lead to further development and refinement of prediction models for these diseases; and investigate correlations between field-based and clinic-based measures of periodontal conditions. Major additions to the ongoing study protocol include expansion of the number of immunofluorescent assays of subgingival plaque for periodontal pathogens to include additional strains of micro-organisms; the addition of assays for salivary immune response factors not studied to date in this project; an expanded investigation of the perceived social impact of oral health and disease on the elderly's personal and professional oral health care behaviors; and the addition of a longitudinal clinical study of 100 subjects that will investigate correlations between periodontal measurements made in field conditions by epidemiologists and those made by periodontists in more ideal clinical conditions. The proposed continuation is the only dental epidemiological study to date to follow a randomly selected cohort of elderly blacks longitudinally or to include assays for periodontal micro-organisms and salivary immune response factors in a study of a representative sample of adults.